Aug. 1, 2011 -- Colon cleansing, promoted as a natural way to boost well-being, has no proven benefits and may be risky, according to a new report.

Ranit Mishori, MD, a family medicine doctor at Georgetown University School of Medicine, looked at studies that evaluated colon hydrotherapy or irrigation. She also looked at studies of cleansing by the use of laxatives, teas, and other products taken by mouth or inserted into the rectum.

"If you are a healthy human being, there is no reason to detoxify yourself using these concoctions or colon hydrotherapy," Mishori tells WebMD.

"The body is designed to detoxify itself," she says. "There is no need to help the body do that. If you are not a healthy person and have heart disease, diabetes, or kidney disease, definitely don't do that."

The study is published in The Journal of Family Practice.

A spokesman from the International Association for Colon Hydrotherapy (IACT) took issue with the report. "Colon hydrotherapy when performed by a trained therapist using FDA registered equipment and disposable speculums or rectal nozzles is safe," says A.R. "Dick" Hoenninger, executive director of the association.

Colon Cleansing: The Report

Although colon cleansing has been around since ancient times, it became popular in the early 1900s, Mishori writes. By 1919, the American Medical Association had condemned the practice. It fell out of favor.

However, in recent years, it has made a comeback, she says. Proponents say it can improve fatigue and boost energy, among other claims.

"This is something I get asked about every week by my patients," she tells WebMD.

In colon hydrotherapy, the patient lies on a table. Water, with or without other substance such as herbs, is pumped through the rectum via a tube. Waste and fluid are expelled by way of another tube.

The cleansing products may include coffee, herbs, probiotics, enzymes, and other substances. They typically are taken by mouth or inserted into the rectum.

Mishori found 20 studies published in the last decade. Although the reports show little evidence of any benefit, many studies reported side effects. These include cramping, bloating, nausea, vomiting, electrolyte imbalance, and kidney failure.

Some herbal preparations have been linked with liver toxicity and aplastic anemia, she says. In aplastic anemia, the bone marrow doesn't make enough new blood cells.

In hydrotherapy, ill effect reports have also included rectal perforation, colitis, and death from intestinal infection, she says.

In the report, Mishori describes two patients she cared for who had colon cleansing. One was hospitalized for dehydration, inflamed pancreas, and other problems. Another had cramps, diarrhea, and vomiting.

"If you want to enhance your sense of well-being, there are many other ways of doing this," she says. On her list: exercise, meditate, go to a yoga retreat, or have a glass of wine with a loved one.

The preparations used for colon cleansing are classified as dietary supplements, Mishori says, so the FDA does not pre-approve them.

The FDA requires that devices used for colonic hydrotherapy meet certain requirements, but no system has been approved for general nonmedical purposes such as routine colon cleansing, she says.

Colon Cleansing: Industry View

Colon hydrotherapists who are members of the IACT use equipment that is classified by the FDA as a class II medical device, Hoenninger says. "It is to be used when medically indicated, such as before radiological or endoscopic examinations," he says.

"Constipation may be one of the medically indicated conditions," he says, with a prescription from a health care provider.

Colon Cleansing: Perspective

"I don't agree there are no benefits,'' says Jamey Wallace, ND, clinic medical director for Bastyr Center for Natural Health of Bastyr University in Seattle.

"If someone is constipated and they have no other medical diagnosis, it can be very helpful," he tells WebMD. He reviewed the study but was not involved in it. He says it can improve bowel function.

Certain people should not consider hydrotherapy, he says. Among them are people with colon cancer, ulcerative colitis, and other bowel problems, he says.

"If a patient is interested in a colonic irrigation they should first see a physician to make sure there are not health concerns that should be addressed medically," he says.

SOURCES:

Mishori R. The Journal of Family Practice, August 2011; vol 60: pp 454-457.

Ranit Mishori, MD, family medicine doctor, Georgetown University School of Medicine, Washington, D.C.